1. Wean off crutches over the next 2-3 days and begin weight bearing as tolerated
   1. If weight bearing precautions have been extended, wean crutches at date instructed.
2. May remove bandage and shower next day but no soaking in tub, swimming, etc for two weeks, keep incisions clean and dry, put band aids on afterwards.
3. Discontinue hip brace as instructed if you were given one.
4. Start simple range of movement exercises as soon as you are comfortable
5. You may use an exercise bike as soon as you are comfortable.
6. Make an appointment to see Dr. Kalman within 7-10 days of your surgery
7. Take anti-inflammatory as prescribed and use pain medication as needed
8. You will be given a prescription for physical therapy at your first post-operative appointment.

*Some patients will encounter a flare up between 6-10 weeks. In this event, it is suggested that you begin a course of Aleve. You may take 2 tablets twice a day with food. This is provided that you are in good health with no outstanding medical conditions and have no known drug allergies to anti-inflammatory medication. If you do have any type of medical condition, including but not limited to hypertension or stomach ulcers, please check with your primary care DO/MD before beginning the medication.

*For our athletes, you may expect a return to sports between 4-6 months.

Day of Surgery

1. Keep leg above heart level as much as possible (ie. couch, pillows)
2. Ice  for 30 minutes at a time while elevating. Ice should be on 30 minutes/ off 1 hour. *Do not ice more than 30 minutes or sleep with ice machine plugged in.

Day After Surgery

1. Call office to make post-operative appointment for 7 days.
2. Ice and elevate as above 4-5 times throughout the day for at least 30 minutes.
3. May Shower, no tub baths or soaking; keep incisions clean and dry. Put band aides on after shower.
4. Start exercises:
   1. Quadricep Squeezes
      1. Squeeze thigh muscle with your leg straight and feel your kneecap slide toward your hip.
      2. Do at least 25 and hold for 3 seconds. Repeat at least 2 times a day. The more the better with these.
   2. Heel Slides
      1. Pull heel toward buttock to flex knee on smooth surface. Can also use a towel or rope to assist. Always work within your range of comfort.
      2. Try to perform 5-10 repetition 3X per day. As always comfort is your guide.
   3. Straight Leg Raises
      1. Have to do in your leg brace if you can’t keep your leg totally straight while lifting it. If your knee bends at all, keep your brace on.
      2. Lay on your back.
      3. Bend your opposite knee.
      4. Make a muscle in your thigh and get your knee as straight as possible and then lift your leg.
      5. Complete 2-3 sets of 10 reps. 2-3 times per day.
5. Ice and elevate after exercises for 30 minutes.

Things to Avoid

1. Walking long distances (ie. mall, grocery store) with leg hanging down
2. Do not walk without immobilizer brace on unless you weren’t given one. Use your crutches until you are told that you do not need them.

Bathing

1. May shower after 24 hours and then blot dry. Then place new dry bandaids over stitches (sutures).
2. Do not soak knee (ie. Bath tub, swimming, hot tubs) for two weeks (unless your doctor states otherwise).

Ask your doctor permission before:

1. Dressing Changes
   1. May change bandages after surgery if bloody. It is normal to see blood.
   2. Rewrap ace wrap 3 times a day.
   3. Do not wrap in circles. Wrap in diagonals as if doing a figure eight around your knee.
   4. Wrap from toes upward
2. Medications
   1. Take medications as instructed when discharged from hospital (surgicenter).
   2. Warning Signs to watch for:
      1. Running a fever, >101F, or >38.5C
      2. Pain markedly increases
   3. *If you have any of these signs, contact your surgeon or the physician on call 302-529-5500.